25 Citations (Scopus)

Abstract

Introduction: Advances in long-acting antiretroviral therapy (ART) can revolutionize current HIV/AIDS treatments. We coined the term ‘long-acting slow effective release ART’ (LASER ART) to highlight the required formulation properties of slow drug dissolution, poor water-solubility, bioavailability, little-to-no off-target toxicities and improved regimen adherence. Drug carrier technologies characterized by high antiretroviral drug (ARV) payloads in a single carrier improve the pharmacokinetic and pharmacodynamic profiles. The surface modifications of ARV carriers target monocyte-macrophages and facilitate drug transport across physiological barriers and to virus-susceptible CD4 + T cells. Areas covered: The review highlights developments of reservoir-targeted LASER ART for improved therapeutic outcomes. Such nanoART delivery platforms include decorated multifunctional nano- and micro-particles, prodrugs and polymer conjugates. Therapeutic strategies such as gene-editing technologies boost ART effectiveness. Expert opinion: The persistence of HIV-1 in lymphoid, gut and nervous system reservoirs poses a challenge to viral eradication. Emerging slow-release drug carriers can target intracellular pathogens, activate antiviral immunity, promote genome editing, sustain drug depots and combine therapeutics with image contrast agents, and can meet unmet clinical needs for HIV-infected patients. Such efforts will bring the medicines to reservoir sites and accelerate viral clearance.

Original languageEnglish (US)
Pages (from-to)1281-1291
Number of pages11
JournalExpert Opinion on Drug Delivery
Volume14
Issue number11
DOIs
StatePublished - Nov 2 2017

Fingerprint

Drug Carriers
Therapeutics
HIV
Pharmaceutical Preparations
Technology
Prodrugs
Expert Testimony
Solubility
Contrast Media
Nervous System
Biological Availability
Antiviral Agents
HIV-1
Monocytes
Immunity
Polymers
Acquired Immunodeficiency Syndrome
Pharmacokinetics
Macrophages
Viruses

Keywords

  • Antiretroviral therapy
  • HIV-1 proviral excision
  • anti-inflammatory activities
  • long-acting slow effective release
  • nanoformulated ART
  • neuroprotection
  • prodrugs
  • targeted drug delivery
  • theranostics
  • viral reservoirs

ASJC Scopus subject areas

  • Pharmaceutical Science

Cite this

Long-acting slow effective release antiretroviral therapy. / Edagwa, Benson J; McMillan, JoEllyn M; Sillman, Brady; Gendelman, Howard Eliot.

In: Expert Opinion on Drug Delivery, Vol. 14, No. 11, 02.11.2017, p. 1281-1291.

Research output: Contribution to journalReview article

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